National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Blood Clots (1)
- Catheter-Associated Urinary Tract Infection (CAUTI) (5)
- Central Line-Associated Bloodstream Infections (CLABSI) (1)
- COVID-19 (1)
- Critical Care (1)
- Education: Patient and Caregiver (1)
- (-) Healthcare-Associated Infections (HAIs) (8)
- Healthcare Costs (2)
- Hospitals (3)
- Infectious Diseases (1)
- Inpatient Care (1)
- Intensive Care Unit (ICU) (1)
- Medicare (1)
- Nursing Homes (1)
- Patient Safety (2)
- Payment (1)
- Pneumonia (1)
- Policy (1)
- Prevention (2)
- Quality Improvement (2)
- Quality of Care (2)
- (-) Urinary Tract Infection (UTI) (8)
AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 8 of 8 Research Studies DisplayedKrauss DM, Molefe A, Hung L
AHRQ Author: Henderson S, Miller M
Emergent themes from a quality improvement programme for CLABSI/CAUTI prevention in ICUs amid the COVID-19 pandemic.
In this study, researchers summarized themes for maintaining infection prevention activities learned from the implementation of a quality improvement (QI) program during the COVID-19 pandemic. They concluded that future shocks such as the pandemic must be anticipated, and the healthcare system must be resilient to the resulting disruptions to healthcare-associated infection prevention activities. Their study encountered four themes for successful maintenance of infection prevention activities during the current pandemic: the value of a pre-existing infection prevention infrastructure; a flexibility in approach; broad buy-in for maintaining QI programs; and the facilitation of idea-sharing.
AHRQ-authored; AHRQ-funded; 233201500016I.
Citation: Krauss DM, Molefe A, Hung L .
Emergent themes from a quality improvement programme for CLABSI/CAUTI prevention in ICUs amid the COVID-19 pandemic.
BMJ Open Qual 2022 Nov;11(4):e001926. doi: 10.1136/bmjoq-2022-001926..
Keywords: COVID-19, Central Line-Associated Bloodstream Infections (CLABSI), Catheter-Associated Urinary Tract Infection (CAUTI), Healthcare-Associated Infections (HAIs), Quality Improvement, Quality of Care, Critical Care, Intensive Care Unit (ICU), Prevention, Urinary Tract Infection (UTI), Infectious Diseases
Lee PT, Krecko LK, Savage S
Which hospital-acquired conditions matter the most in trauma? An evidence-based approach for prioritizing trauma program improvement.
The purpose of this study was to quantify and compare the impacts of six different hospital-acquired conditions (HACs) on early clinical outcomes and resource utilization in hospitalized trauma patients. The researchers included 529,856 adult patients from the 2013 to 2016 American College of Surgeons Trauma Quality Improvement Program Participant Use Data Files with 5 days or longer of hospitalization and had an Injury Severity Score of 9 or higher. The study found the incidences of HACs were: pneumonia, 5.2%; urinary tract infection, 3.4%; venous thromboembolism, 3.3%; surgical site infection, 1.3%; pressure ulcer, 1.3%; and central line-associated blood stream infection, 0.2%. The HAC of pneumonia demonstrated the largest association with in-hospital outcomes and resource utilization. The researchers reported that prevention of pneumonia within the study group would have resulted in estimated reductions of: 22.1% for end organ dysfunction, 8.7% for prolonged hospitalization, 7.8% for mortality, 7.1% for prolonged intensive care unit stay, and 6.8% for need for mechanical ventilation. The researchers concluded that pneumonia prevention should be a priority activity in program improvement efforts.
AHRQ-funded; HS025224.
Citation: Lee PT, Krecko LK, Savage S .
Which hospital-acquired conditions matter the most in trauma? An evidence-based approach for prioritizing trauma program improvement.
J Trauma Acute Care Surg 2022 Oct 1;93(4):446-52. doi: 10.1097/ta.0000000000003645..
Keywords: Healthcare-Associated Infections (HAIs), Hospitals, Pneumonia, Urinary Tract Infection (UTI), Blood Clots
MacEwan SR, Beal EW, Gaughan AA
Perspectives of hospital leaders and staff on patient education for the prevention of healthcare-associated infections.
The purpose of this study was to contribute to evidence of standardized approaches to educate patients about how they can prevent infections. The researchers explored the perspectives of hospital leaders and staff across 18 hospitals about patient education for device-related healthcare-associated infections (HAIs) including catheter-associated urinary tract infections (CAUTIs) and central-line-associated bloodstream infections (CLABSIs). A total of 471 interviews were conducted with key informants and analyzed to identify themes within the topic of preventing infection through patient education. The study found that the key informants identified CAUTI and CLABSI infection-prevention-specific patient education topics including: the necessity of hand hygiene, the importance of maintenance care, the risks of indwelling urinary catheters and central lines, and having the support to voice concerns. The study concluded that hospital leaders and staff identified patient education topics and ways to deliver the information that were important in the prevention of CAUTIs and CLABSIs, and can provide guidance on how patient education can be improved.
AHRQ-funded; HS024958.
Citation: MacEwan SR, Beal EW, Gaughan AA .
Perspectives of hospital leaders and staff on patient education for the prevention of healthcare-associated infections.
Infect Control Hosp Epidemiol 2022 Sep;43(9):1129-34. doi: 10.1017/ice.2021.271..
Keywords: Healthcare-Associated Infections (HAIs), Prevention, Education: Patient and Caregiver, Catheter-Associated Urinary Tract Infection (CAUTI), Urinary Tract Infection (UTI)
Makic MBF, Stevens KR, Gritz RM
AHRQ Author: Rodrick D
Dashboard design to identify and balance competing risk of multiple hospital-acquired conditions.
A national patient safety priority is hospital-acquired conditions (HACs) such as falls, hospital-acquired pressure injuries (HAPI), and catheter-associated urinary tract infections (CAUTIs). Most HAC prevention interventions focus on each risk individually, and do not take into consideration how addressing one HAC independently can compete with other HACs and cause unintended consequences. The purpose of this proof-of-concept study was to design a framework to identify, evaluate, and quantify competing individual HAC interventions and the related risks of multiple HACs (MHACs), and design a dashboard to help guide provider decisions. The researchers focused on the how the removal of urinary catheters for reduction of CAUTI could unintentionally impact falls and HAPI. A database to quantify the competing risks of HACs was developed using data from five hospital systems; three of those hospitals tested the resulting predictive model dashboard developed by the researchers and provided feedback. Twenty-five clinicians participated in the qualitative interviews. The clinicians confirmed that a visual dashboard is useful for guiding their decision-making for MHAC risks, and preferred a red, green, yellow stoplight visual for understanding. The researchers also found that clinicians did not want mandatory alerts for tool integration into the electronic health record. The study concluded that additional research is needed to better understand multiple hospital acquired risks and methods for guiding provider decision-making.
AHRQ-authored; AHRQ-funded; 2332015000251.
Citation: Makic MBF, Stevens KR, Gritz RM .
Dashboard design to identify and balance competing risk of multiple hospital-acquired conditions.
Appl Clin Inform 2022 May;13(3):621-31. doi: 10.1055/s-0042-1749598..
Keywords: Healthcare-Associated Infections (HAIs), Catheter-Associated Urinary Tract Infection (CAUTI), Urinary Tract Infection (UTI)
McCleskey SG, Shek L, Grein J
Economic evaluation of quality improvement interventions to prevent catheter-associated urinary tract infections in the hospital setting: a systematic review.
This systematic review looked at economic evaluations of quality improvement (QI) interventions to reduce rates of catheter-associated urinary tract infections (CAUTIs). A literature review was conducted for conference abstracts and studies from January 2000 to October 2020. Dual reviewers assessed study design, effectiveness, costs and study quality for eligibility. The reviewers performed a cost-consequence analysis from the hospital perspective, estimating the incidence rate ratio and increment net cost/savings per hospital over 3 years for each eligible study. Fifteen unique economic evaluations were eligible, and 12 studies were amenable to standardization. QI interventions were associated with a 43% decline in infections and wide ranges of net costs relative to usual care.
AHRQ-funded; HS022644.
Citation: McCleskey SG, Shek L, Grein J .
Economic evaluation of quality improvement interventions to prevent catheter-associated urinary tract infections in the hospital setting: a systematic review.
BMJ Qual Saf 2022 Apr;31(4):308-21. doi: 10.1136/bmjqs-2021-013839..
Keywords: Quality Improvement, Quality of Care, Urinary Tract Infection (UTI), Healthcare-Associated Infections (HAIs), Hospitals, Healthcare Costs
Kawai AT, Calderwood MS, Jin R
Impact of the Centers for Medicare and Medicaid services hospital-acquired conditions policy on billing rates for 2 targeted healthcare-associated infections.
The 2008 Centers for Medicare & Medicaid Services (CMS) hospital-acquired conditions policy limited additional payment for conditions deemed reasonably preventable. This study examined whether this policy was associated with decreases in billing rates for 2 targeted conditions, vascular catheter-associated infections (VCAI) and catheter-associated urinary tract infections (CAUTI). The CMS policy appears to have been associated with immediate reductions in billing rates for VCAI and CAUTI, followed by a slight decreasing trend or leveling-off in rates.
AHRQ-funded; HS018414.
Citation: Kawai AT, Calderwood MS, Jin R .
Impact of the Centers for Medicare and Medicaid services hospital-acquired conditions policy on billing rates for 2 targeted healthcare-associated infections.
Infect Control Hosp Epidemiol 2015 Aug;36(8):871-7. doi: 10.1017/ice.2015.86.
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Keywords: Healthcare-Associated Infections (HAIs), Policy, Medicare, Payment, Hospitals, Catheter-Associated Urinary Tract Infection (CAUTI), Urinary Tract Infection (UTI), Healthcare Costs
Mody L, Meddings J, Edson BS
Enhancing resident safety by preventing healthcare-associated infection: a national initiative to reduce catheter-associated urinary tract infections in nursing homes.
The authors describe a new initiative based on lessons learned from a recent multimodal Targeted Infection Prevention program in a group of nursing homes as well as a national initiative to prevent catheter-associated urinary tract infections in over 950 acute care hospitals. This initiative will now be implemented in nearly 500 nursing homes through a project funded by AHRQ. It will emphasize professional development in catheter utilization, catheter care and maintenance, and antimicrobial stewardship.
AHRQ-funded; 2902010000251; HS019979; HS019767.
Citation: Mody L, Meddings J, Edson BS .
Enhancing resident safety by preventing healthcare-associated infection: a national initiative to reduce catheter-associated urinary tract infections in nursing homes.
Clin Infect Dis 2015 Jul 1;61(1):86-94. doi: 10.1093/cid/civ236..
Keywords: Nursing Homes, Healthcare-Associated Infections (HAIs), Urinary Tract Infection (UTI), Patient Safety, Inpatient Care
Dicks KV, Baker AW, Durkin MJ
The potential impact of excluding funguria from the surveillance definition of catheter-associated urinary tract infection.
The authors examined surveillance data from a network of community hospitals as well as a tertiary-care medical center to describe the potential impact of excluding yeast as a urinary pathogen from the catheter-associated urinary tract infection (CAUTI) definition on CAUTI rates. They found that excluding yeast from the CAUTI surveillance definition reduced CAUTI rates by nearly 25% in the studied medical centers.
AHRQ-funded; HS023866.
Citation: Dicks KV, Baker AW, Durkin MJ .
The potential impact of excluding funguria from the surveillance definition of catheter-associated urinary tract infection.
Infect Control Hosp Epidemiol 2015 Apr;36(4):467-9. doi: 10.1017/ice.2014.72.
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Keywords: Catheter-Associated Urinary Tract Infection (CAUTI), Healthcare-Associated Infections (HAIs), Patient Safety, Urinary Tract Infection (UTI)